Family-based prevention of overweight and obesity in children aged 2–6 years: a systematic review and narrative analysis of randomized controlled trials

ABSTRACT Overweight and obesity in childhood are highly preventable and parents are key role models in the establishment of healthy behaviours. The aim of this study was to assess the effectiveness of family-based interventions for prevention of overweight and obesity in children aged 2–6 years. A systematic literature search was performed in the databases such as Medline, PsycInfo, Family Study Abstracts, Embase, and CINAHL, published between 2010 and May 2019. The eligible studies were preventive randomised controlled interventions targeting the child or the child’s caregivers. The primary outcome was body mass index (BMI). Twelve trials were included with a total of 3506 participants. The overall follow-up rate in the intervention groups was 83% as compared to 82% in the control groups. Nine trials had a high or unclear risk of bias. The children were followed for between 6 weeks and 3 years. Four of the interventions showed significant intervention effects on BMI. Significant effects on children’s food intake were reported in one (of five) study, whereas no significant changes in physical activity were found (six studies). Two studies (of six) measuring sedentary behaviours and one (of three) measuring sleep showed significant differences between groups favouring the intervention group. The current evidence for the effects of preventive family interventions is limited. The four trials showing positive effects on BMI were multicomponent interventions, lasting for a minimum of 12 weekly sessions.